1. Field of the Invention
The invention relates generally to medical devices utilized during surgical suturing, specifically, the art of anastomosis. In particular, the invention relates to a device for holding tubularly-shaped body ducts, such as blood vessels, during anastomosis.
2. Scope of the Prior Art
When performing heart surgery, and other surgery involving blood vessels and other body ducts, the job of anastomosing one vessel to another is normally performed by stitching edges of blood vessel openings together. The need for satisfactorily holding adjacent blood vessels during anastomosis is well recognized, and various solutions have been developed for meeting the need.
During vein bypass graft surgery, for example, forceps are commonly used to hold and suspend the slanted or beveled open end (fish mouth opening) of a vein in close proximity to the opening on the wall of the aorta while sutures are being taken. However, the forceps can easily slip from its position during the anastomosis. Moreover, the inner wall of the vein is very susceptible to damage due to the holding or stretching of the vein by the forceps. Yet further, the vein has a tendency to collapse which only increases the difficulty in suturing the graft to the aorta.
Another solution is disclosed in U.S. Pat. No. 4,651,733 issued to Mobin-Uddin. The Mobin-Uddin device is an elongated rod having a holder on one end, a shank portion in the middle, and a prong on the other end. The prong has a sharply pointed hook extending laterally, and preferably in a rearwardly direction, therefrom. The prong is inserted into the open end of a blood vessel until the hook reaches the distal end of the vessel. The hook pierces the vessel wall to lock the vessel onto the prong whereupon the device "holds" the blood vessel in the desired position at the outset of the anastomosis.
The invention provides a means for holding a vein during vascular surgery without piercing the wall of the vein, and without placing unnecessary stresses on the vein. In one aspect of the invention, a holding device is provided for holding a vein during vascular surgery. The device comprises a substantially rigid elongated rod having a shank portion and a terminal portion connected to the shank portion. The terminal portion has a bulbous section spaced from the shank portion, and the outer surface of the terminal portion is free of discontinuities. The bulbous section has a cross-sectional dimension slightly less than the diameter of the vein so that the terminal portion can be received within the vein. When the diameter of the vein between the bulbous section and the shank portion is reduced, the bulbous section will resist withdrawal of the vein.
Preferably, the terminal portion has a terminus and the bulbous section is located at the terminus. Also, preferably the terminal portion will not be co-linear with the shank portion.
In another aspect of the invention, the rod is formed in one piece, and the shank portion has means for gripping the rod. Preferably, the shank portion is longer than the terminal portion.
The shank portion and terminal portion can be integrally formed so that the elongated rod is a unitary structure.
In another aspect of the invention, a holding assembly is provided for holding a vein during vascular surgery. The assembly comprises a substantially rigid elongated rod having a shank portion and an integral terminal portion. Engagement means are provided to cause the terminal portion to functionally engage and retain the interior wall of the vein against movement relative to the rod without placing point stresses on the interior wall. Preferably, the engagement means comprises a bulb integrally connected to the terminal portion. The engagement means further comprises a tie adapted to be disposed around the outer wall of the vein.
In yet another aspect of the invention, a method is described for holding a vein during vascular surgery. The method comprises the steps of providing a substantially rigid elongate rod having a shank portion and a terminal portion. The terminal portion has a bulbous section spaced from the shank portion, and the outer surface of the terminal portion is free of discontinuities. The bulbous section is inserted into the vein so that a portion of the vein is disposed between the bulbous section and the shank portion. The portion of the vein between the bulbous section and the shank portion is then reduced, and the shank portion of the rod can be grasped to hold the vein in a predetermined position for surgery. Preferably, the diameter of the vein is reduced by tying a cord around the portion of the vein between the bulbous section and the shank portion.